Access & Reimbursement Manager, Cardiovascular
Kerr Dental
full-time
Posted on:
Location Type: Remote
Location: Remote • New Mexico, Oklahoma, Texas • 🇺🇸 United States
Visit company websiteSalary
💰 $138,600 - $257,400 per year
Job Level
Mid-LevelSenior
About the role
- Interact within assigned accounts to support patient access within their therapeutic area product(s) providing proactive face-to-face education on product-specific programs to providers and staff in order to support integration of those programs into office processes and workflows.
- Address customer questions for issues related to NPC policies on therapeutic area product ordering, payment, inventorying, and product returns & replacement in offices.
- Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.
- Analyze problems and offer solutions.
- Understand specifics and support questions associated with payer policies (e.g., utilization management, denial, and appeals), drug acquisition and inventory management, and patient / practice reimbursement (e.g., Co-pay, administration, drug claims).
- Analyze account reimbursement issues & opportunities (as needed).
- Identifies trends at a local, regional and national level and partner with purpose internally and externally to support patient pull-through.
- Supports pull through on local coverage decisions to enable meaningful patient access within the system.
- Proactively communicate policy changes or issues that could potentially affect other departments.
- Responsible for standing up NVS-sponsored patient support programs to enable patients starting and staying on therapy (i.e., Co-pay).
Requirements
- Bachelor’s Degree required
- Advanced degree preferred
- Minimum three to five years' experience in public or private third-party Reimbursement arena or pharmaceutical industry in managed care, clinical support, or sales.
- Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and bill)
- Experience with coding, billing and in office support programs
- Prior account management experience or prior experience with complex accounts (Payer landscape, high patient volume, large systems)
- Specialty pharmacy experience required (ability to teach an office the entire process from script to injection)
- Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy) a plus
- Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems a plus
- Ability to operate as a "team player" in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reach common goals
- Ability to travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory / targeting make up.
- Must live within assigned territory.
- Driving is an essential function of this role, meaning it is fundamental to the purpose of this job and cannot be eliminated. Because driving is an essential function of the role, you must have a fully valid and unrestricted driver’s license to be qualified for this role.
Benefits
- Medical benefits
- Financial benefits
- Paid time off benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
codingbillingaccount managementreimbursement analysispatient access supportspecialty pharmacy experiencedrug claims managementutilization managementinventory managementclaims processing
Soft skills
problem solvingcommunicationcollaborationteam playerproactive educationtrend analysiscustomer serviceorganizational skillsadaptabilityinterpersonal skills
Certifications
Bachelor's DegreeAdvanced degree (preferred)